Open surgery traditionally involves operative procedures in which one or more large incisions are made in a patient. The incision and the dissection required for access and visualization by the surgeon during the operative procedure contributes to increased pain to and delayed recovery of the patient.
Minimally invasive surgery is a cost-effective alternate to open surgery whereby the operative procedures are performed using specialized surgical instruments designed to fit into the body through one or more small incisions. The surgeon monitors the operative procedure on a display via an endoscopic camera inserted through one of the small incisions. By eliminating large incisions and extensive dissections, the pain to the patient and the time for recovery is reduced.
Surgical instruments for assisting a surgeon in minimally invasive surgery typically have an elongated body with a handle at one end and an end effector such as a grasper or scissors at the other end. The surgeon inserts the end effector through a small incision in the patient and manipulates the instrument by pivoting it about the incision, rotating it about the incision, sliding it through the incision, and actuating the end effector.
Teleoperated systems have been employed in which a pair of surgical instruments are coupled to a pair of robotic arms. The robotic arms are coupled via a controller to a pair of master handles. The master handles can be moved and actuated by the surgeon to produce a corresponding movement of the surgical instrument and actuation of the end effector.
Compared to open surgery, minimally invasive surgery is affected by physical, visual, motor, spatial, and haptic constraints. As a result of these constraints, there is an extended learning curve that surgeons must go through to gain the required skill and dexterity. Furthermore, there is a great deal of variability even among trained surgeons. Time motion studies of minimally invasive surgeries indicate that for operations such as tissue dissection, suturing, knot tying, and suture cutting, the operation time variation between surgeons can be as large as fifty percent. In suturing, it is noted that the major difference between surgeons lies in the proficiency of the surgeon at grasping a needle and moving the needle to a desired position and orientation without slipping or dropping the needle.
A drawback with use of the above-noted surgical instruments and teleoperated systems for minimally invasive surgery is that a high level of dexterity is required to accurately control the position of the surgical instrument and actuate the end effector. Another drawback is that the handles and end effector have a master-slave relationship so that movement of the handles causes a corresponding movement of the end effector. Still another drawback is that minimally invasive surgery requires usage of a variety of different surgical instruments during an operative procedure which requires the surgeon to switch between different surgical instruments and position each surgical instrument in the patient before continuing the operative procedure.
Therefore, there exists a need for a compact system for minimally invasive surgery in which the system includes one or more docking stations for controlling the position of one or more releasably attachable surgical tools and in which the docking station and an end effector of the surgical tool are manually controllable solely by a surgeon, collaboratively controllable by both the surgeon and computer, or autonomously controllable by a computer, e.g., in tying a knot in suturing.